Drug Guide

Generic Name

Gallium Nitrate

Brand Names Ganite

Classification

Therapeutic: Antineoplastic agent, Hypercalcemia of malignancy treatment

Pharmacological: Gallium compound, Metal compound

FDA Approved Indications

  • Hypercalcemia of malignancy refractory to hydration and bisphosphonates

Mechanism of Action

Gallium nitrate inhibits osteoclast-mediated bone resorption and has antitumor activity, possibly through interference with the tumor cell metabolism and immune modulation.

Dosage and Administration

Adult: 25 mg/m2 IV over 30 minutes, repeated every 3–4 weeks as needed

Pediatric: Not typically used in pediatric population

Geriatric: Adjust dose based on renal function, similar to adults

Renal Impairment: Reduced doses may be necessary based on renal function; monitor renal parameters closely

Hepatic Impairment: No specific adjustment known

Pharmacokinetics

Absorption: Not applicable; administered IV

Distribution: Widely distributed, including bone and soft tissues

Metabolism: Not extensively metabolized

Excretion: Primarily renal excretion

Half Life: Approximately 5–7 days, prolonged in renal impairment

Contraindications

  • Known hypersensitivity to gallium nitrate or components

Precautions

  • Renal impairment—use with caution; monitor renal function closely
  • Electrolyte imbalances—correct prior to therapy
  • Infusion reactions—monitor during administration

Adverse Reactions - Common

  • Nausea (Common)
  • Vomiting (Common)
  • Flushing (Common)
  • Nephrotoxicity (Potentially serious)
  • Electrolyte disturbances (hypokalemia, hypomagnesemia) (Common)

Adverse Reactions - Serious

  • Renal failure (Serious)
  • Arrhythmias related to electrolyte abnormalities (Serious)
  • Myelosuppression (Potentially serious)

Drug-Drug Interactions

  • Nephrotoxic drugs (e.g., aminoglycosides, amphotericin B)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal function (BUN, serum creatinine), electrolytes, and complete blood count before and during therapy.

Diagnoses:

  • Risk for renal impairment
  • Electrolyte imbalance

Implementation: Administer IV infusion over 30 minutes as prescribed. Hydrate the patient adequately before administration.

Evaluation: Assess for signs of hypocalcemia, electrolyte disturbances, and renal function deterioration.

Patient/Family Teaching

  • Report any symptoms of kidney problems (e.g., decreased urine output, swelling).
  • Maintain hydration and follow dietary recommendations.
  • Inform about potential side effects, including flushing and gastrointestinal discomfort.

Special Considerations

Black Box Warnings:

  • Renal toxicity—use caution and monitor renal function closely

Genetic Factors: None specific

Lab Test Interference: May cause transient increases in serum calcium; interpret labs accordingly.

Overdose Management

Signs/Symptoms: Severe hypocalcemia, renal failure, electrolyte disturbances

Treatment: Discontinue gallium nitrate, provide supportive care, correct electrolytes, maintain hydration, and consider dialysis if necessary.

Storage and Handling

Storage: Store at room temperature, protected from light

Stability: Stable under recommended conditions, discard unused portion after expiration or if particulate matter or discoloration occurs.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.